Blaming the Victim

David Leonhardt of the New York Times had an excellent column today that dissected the medical economics of invasive cardiology. Angioplasty and stents don't help most patients; at least 20 percent are unnecessary, according to Eric Topol of the Scripps Research Institute. But physicians and stent manufacturers are making money hand over fist. Who's going to say no, he asks.

The article sounded one off-key note. "We patients deserve some of the blame, too. We’ve come to believe that aggressive treatment somehow offers us the best chance to stay healthy, even when the evidence says otherwise," Leonhardt wrote.

That doesn't sound right to me. I know people demand particular drugs, especially after they've seen them advertised. But I have a hard time imagining patients with heart troubles demanding a particular invasive procedure from their doctor. "You mean you're not going to insert a drug-eluting stent?"

I think I'm on safe ground when I say that this is one area where providers are wholly to blame for chronic overuse of these procedures.